On Wednesday, May 2, 2018, Iowa legislators passed "the heartbeat bill." The legislation bans abortions once a fetal heartbeat is detected. Essentially, the heartbeat distinction would ban abortions by the sixth week of pregnancy.

Opposition to the bill claims that it would ban abortions before some women even know they're pregnant.

The passage of the bill comes as the Trump administration has taken a hard-line stance on abortion, spurring a slew of abortion laws across the nation.

Nineteen states adopted a total of 63 restrictions to the procedure in 2017, which is the highest number of state laws on the issue since 2013, according to the Guttmacher Institute.

The bill now goes to Gov. Kim Reynolds's (R) desk, but, if signed, is expected to be challenged as a violation of Supreme Court precedent including Roe v. Wade.

The Gestational Age Act, signed into law by Mississippi Governor Phil Bryant on March 19, has already been judicially blocked.

The law bans abortions after 15 weeks and is the toughest restriction on abortion in the nation.

In response to the legislation, Mississippi's only abortion clinic sued, and U.S. District Judge Carlton Reeves granted a temporary restraining order on Tuesday, March 20.

Mississippi was already one of the toughest states in which to receive an abortion before the new law was signed. The state requires people seeking abortions to receive counseling and to wait 24 hours before receiving the procedure.

Mississippi Governor Phil Bryant signed into law the Gestational Age Act on Monday, March 19, officially banning abortions after 15 weeks of pregnancy. The legislature had initially passed the bill on March 8, 2018.

There is only one clinic in Mississippi that performs abortions; they have already sued the state in response to the legislation.

After signing the bill, the Governor said: "We are saving more of the unborn than any state in America, and what better thing we could do...We'll probably be sued here in about a half hour, and that'll be fine with me. It is worth fighting over."

A committee of lawmakers in the Mississippi Senate passed House Bill 1510, which would ban abortions after 15 weeks of pregnancy. While the bill provides exceptions for medical emergencies or certain cases of fetal abnormalities, it does not except rape or incest. The House originally proposed and passed the bill earlier in February of this year.

Mississippi Governor Phil Bryant (R) has previously stated his goal is to completely end abortions in Mississippi, and has affirmed he would sign the bill if it lands on his desk.

Mississippi already proscribes abortions after 20 weeks, a law that was originally defended on the basis of preventing fetal pain, despite research that shows a fetus may not feel pain until 27 weeks.

As many people do not find out they are pregnant for several weeks, or even months, pro-choice advocates are concerned about the difficulty a 15-week ban imposes on persons who would seek an abortion but do not discover their pregnancy in time.

20-week bans have been proposed and judicially struck down in Arizona and Idaho, however there has been no challenge yet to Mississippi's current 20-week ban. It's likely the new bill, if made law, would be challenged in court.

Following a 5-2 Ohio Supreme Court ruling issued on February 6th ordering the closure of Toledo, Ohio's last abortion clinic for violating state law, the future of the clinic and of abortion access in northwest Ohio looked all too grim...until this past Monday the 12th.

After hours of protesting near ProMedica Toledo Hospital on Monday to call on ProMedica to enter into a patient-transfer agreement that would keep Capital Care Network, Toledo’s last abortion clinic, open, the hospital system’s board of trustees authorized the agreement.

In its decision ordering Capital Care Network to close, the Ohio Supreme Court cited that the clinic's hospital transfer agreement with the University of Michigan in Ann Arbor did not comply with the Ohio Department of Health's 30-minute transport time standard. The department had revoked Capital Care Network's license in 2014.

Following the enactment of a 2013 law requiring all abortion clinics in Ohio to maintain emergency patient-transfer agreements with local hospitals, Capital Care Network sued the state, arguing that the law presented an undue burden on abortion access in Ohio. While the lower courts sided with the clinic, the Ohio Supreme Court refused to tackle the state law's constitutional issues, instead finding that the state "had authority to revoke Capital Care's license based on the failure to comply with the administrative rule" promulgated by the Ohio Department of Health. Unless Capital Care Network could sign an agreement with a hospital within the 30-minute travel requirement, it would be forced to close.

Capital Care previously maintained an agreement with the University of Toledo Medical Center until 2013, when the hospital opted not to renew it. The Ohio legislature then prohibited publicly funded universities from providing transfer agreements to abortion clinics.

In its statement announcing the new agreement with Capital Care, ProMedica spokesperson Tedra White wrote, “entering into this agreement aligns with ProMedica’s mission and values, including our focus on being a health system dedicated to the well-being of northwest Ohio and our belief that no one is beyond the reach of life-saving health care.” “Furthermore," she wrote, "we believe that all individuals should have access to the best care in their neighborhoods.”

Jennifer Branch, an attorney representing Capital Care, said that once she obtains a copy of the transfer agreement, she will file documents with the Ohio Department of Health to halt license-revocation proceedings against the clinic.

Ohio has endured a wave of new laws restricting access to abortion care across the state over the past few years. Under Governor John Kasich, the number of abortion clinics in Ohio has dropped from sixteen to eight. Three are in the Cleveland-Akron area, two in Columbus, and one each in Toledo, Dayton, and Cincinnati. For now, thanks to ProMedica, the number will stand at eight.

The Supreme Court has granted certiorari to hear NIFLA vs. Becerra, in which an anti-abortion group challenges a California law that requires crisis pregnancy centers to notify patients that the state offers contraception and abortion services.

The case centers on the Reproductive FACT Act, which requires pregnancy centers to disclose whether they have a medical license and whether medical professionals are available. The law also requires centers to post a notice in the waiting room that reads: "California has public programs that provide immediate free or low-cost access to comprehensive family planning services, including all FDA-approved methods of contraception, pre-natal care and abortion."

California lawmakers passed the disclosure law two years ago after concluding as many as 200 pregnancy centers in the state sometimes used “intentionally deceptive advertising and counseling practices that often confuse, misinform and even intimidate women” about their options for medical care.

The National Institute of Family and Life Advocates (NIFLA) represents 110 pregnancy centers in California that all claim the disclosure provision violates their free speech as "compelled speech." Such a disclosure, they claim, conflicts with their faith-based goal of encouraging childbirth and preventing abortion.

The Californian pregnancy centers initially lost their case under three federal district judges. On appeal, the 9th Circuit Court upheld the lower court's decision. Last month, however, a judge in Riverside County ruled that the law violated the free-speech provisions of California's own state Constitution.

California's Attorney General Xavier Becerra stands by the disclosure provision and its intent to provide women accurate information about their health care options.

It takes five justices for a majority opinion, and many expect the Court's decision to turn on the vote of Justice Kennedy.

Earlier this month, Texas Governor Greg Abbott signed Senate Bill 8 into law, "an omnibus measure that mandates burdensome clinic regulations and outlaws a safe, common abortion procedure" known as dilation & evacuation, or D&E. SB 8 is the most sweeping set of restrictions on abortion care signed into law in Texas since House Bill 2 in 2013, culminating in last year's Whole Woman's Health v. Hellerstedt ruling by the U.S. Supreme Court that struck down two of the bill's major provisions. A lawsuit against SB 8 is expected later this summer.

Novack argues that while abortion-rights advocates ultimately claimed victory in the courts over HB 2, the law "forced the closure of more than half the state’s abortion clinics, and only three have reopened since." The main issue for abortion-rights advocates, Novack says is that "legislation often moves faster than the courts, and SB 8 could wreak similar havoc on the abortion provider community in Texas.

“We’re looking at again the possibility of clinic closures and other restrictions that force women to leave the state if they need abortion care,' said Amanda Allen, senior state legislative counsel at the Center for Reproductive Rights, which filed the lawsuit against HB 2 and has pledged to fight SB 8. 'In terms of access on the ground, this presents a huge threat to Texas.”

The major provisions at issue in SB 8 are a requirement that fetal remains be buried or cremated, and a ban on D&E, the most common form of second-trimester procedure. Abortion-rights advocates take some comfort in knowing that both of these provisions have been successfully challenged in court, but if either provision goes into effect, clinics could face closure for failure to comply with the law.

Texas Right to Life pushed the D&E ban, while Texas Alliance for Life championed the fetal burial/cremation requirement. Each group has a different strategy: Texas Right to Life favors pushing the D&E ban to the Supreme Court, while Texas Alliance for Life favors "a more incremental approach" that chips away at access until the Supreme Court becomes less favorable to abortion rights. Said Joe Pojman, executive director of Texas Alliance for Life: "it’s very clear now that [Justice Kennedy] will not uphold any state or federal provision that makes abortion less accessible, that’s the unfortunate reality."

In January, a federal judge blocked new Texas regulations that would’ve required burials for fetal remains. Courts have blocked D&E abortion bans in four other states. While it remains to be seen how courts will decide on SB 8, the battle will be long, and if it plays out like HB 2, there could be lasting consequences.

Two laws hindering women from obtaining safe abortions have been dismantled in Idaho. The first curtailed the use of telemedicine to assist women choosing medical abortions. Telemedicine allows physicians to consult with their patients remotely. It can be especially useful in delivering medical services in rural areas. The law required a physician to be present when a patient receives abortion-inducing medication. The second law simply forbade physicians from prescribing pregnancy-ending drugs remotely.

Planned Parenthood sued Idaho to dismantle these laws. A settlement entered into between the parties requires Idaho to repeal these laws by 2017 or have them declared unconstitutional in federal court. A federal judge has already ruled that requiring a physician's physical presence imposes an undue burden on women seeking medical abortions with no counterbalancing health benefits. A similar restriction was struck down by the Iowa Supreme Court in 2015.

Ohio has new law that bans abortion after 20 weeks of pregnancy. There is no exception for rape or incest. Ohio is the eighteenth state to adopt the 20-week ban. Federal courts in Arizona and Idaho have struck down similar laws as unconstitutional. The Supreme Court has refused to hear Arizona's appeal.

A more restrictive measure, banning abortion after a fetus has a detectable heartbeat, was vetoed by Governor Kasich. Many believe that the advent of Trump emboldened legislators to vote in favor of the heartbeat bill, despite it having been a perennial failure in the past.

The effects of Mr. Trump’s victory are only beginning to be felt. But one of the biggest changes is playing out in abortion politics. From the composition of the Supreme Court (Mr. Trump has promised to nominate staunchly anti-abortion justices), to efforts on Capitol Hill to enact a permanent ban on taxpayer-financed abortions, to emboldened Republican statehouses like the one in Ohio, combatants on both sides see legalized abortion imperiled as it has not been for decades.

Trump's election follows on a decade of anti-abortion victories throughout the country. Rights-preserving states like New York and California are becoming more the exception than the norm. Anti-abortion groups are mobilizing to harness what they perceive to be an increasingly promising landscape for enacting abortion restrictions. Americans United for Life, for example, recently released a report that purports to chronicle a raft of unsafe conditions in America's abortion clinics. The group hopes the publication will inspire legislatures to pass abortion restrictions in the wake of Whole Woman's Health v. Hellerstedt. In Texas specifically, conservative legislators have promised "'an absolute onslaught of pro-life legislation.'" Four other states have enacted "trigger bans" on abortion that will take effect immediately if Roe v. Wadeis overruled.

Before his election, Trump committed in writing to four anti-abortion priorities:

Those priorities include putting anti-abortion justices on the Supreme Court; passing a national 20-week ban like Ohio’s; eliminating federal money for Planned Parenthood as long as its clinics perform abortions; and making permanent the Hyde Amendment, passed annually by Congress to ban taxpayer-funded abortions.

Malin writes, "New York is a place where everyone is welcome and where we believe that everyone deserves access to the resources to achieve their dreams." In the area of abortion liberty, New York has been in the vanguard. Abortion was legal here before Roe v. Wade, the state provides Medicaid coverage for abortion services and requires health insurance coverage for birth control. But the current Senate majority is hostile to reproductive rights and has stymied forward progress. It has blocked the Women's Equality Act for three years in a row and has not been a friend to measures that would have eliminated barriers to birth control and would have barred employment discrimination on the basis of an employee's reproductive health decisions.

The good news is that Senators Toby Ann Stavisky and Gustavo Rivera have won in their primary contests against challengers who vowed to roll back reproductive rights in New York State. Businessman S.J. Jung does not support a woman's right to choose, even in cases of rape and incest. Fernando Cabrera champions "anti-abortion Crisis Pregnancy Centers that mislead women about their reproductive health care options." Both Jung and Cabrera have gone out of their way to express their disapproval of equal rights for same-sex couples and gay individuals.

New York has a rich history of championing reproductive rights, even if no progress has been made in recent years. With Democratic candidates for Senate like Stavisky and Rivera, come November voters will have a golden opportunity to show their support for reproductive liberty.

In the wake of the landmark victory of Whole Women's Health v. Hellerstedt, Amanda Marcotte argues that the anti-choice movement has been "sent back to the drawing board" and their two new tactics are spins on old classics: "first, trying to trick people into thinking embryos are babies and then trying to trick people into thinking abortion is too medically dangerous to be allowed." Some newly proposed regulations in Texas, Louisiana and Indiana require women to have a funeral for the 'remains' of a miscarriage or abortion. So far the regulations have been held up in the court.

While these regulations are said to have been "quietly" proposed, anti-choice advocates are a little louder about making claims that abortions are dangerous. Their problem is that statistics published by places like the CDC and Guttmacher show that abortion is extremely safe. Rather than changing their claims, anti-choice supporters argue that they just need more statistics. While these claims seem ridiculous, Marcotte argues that there's a silver lining:

Considering the lengthy history of anti-choice violence against medical providers, this kind of behavior is deeply worrisome.But it also shows the depths of desperation of the anti-choice movement. More data collection will just prove how safe abortion is, and funerals for embryos just remind everyone what kind of sick fantasy lives anti-choice activists have.

In the wake of the Supreme Court's decision in Whole Woman's Health v. Hellerstedt, anti-abortion forces are reconsidering whether the strategy they have pursued for the last several years was ill-conceived. A new strategy among some groups is to lobby legislatures, at both the federal and state levels, to ban abortion after roughly twenty weeks of pregnancy and to ban all dilation and evacuation abortions. A federal bill to this effect passed the House but was defeated in the Senate.

But some anti-abortion groups want to continue fighting for TRAP (targeted regulation of abortion providers) laws and remain convinced that there is a way to formulate such laws that will pass constitutional scrutiny. Thus, the anti-abortion movement is currently divided into two camps, those who want to continue the battle to shut down abortion care clinics in the guise of fighting for women's health, and those who desire a renewed focus on banning abortion outright.

Anti-abortion forces remain convinced that they are winning the fight, despite recent setbacks and despite the social justice leanings of the up and coming generation of millennials. They view the question of who will inhabit the White House come next January as the factor that will be the most decisive in the short term.

In the wake of Whole Woman's Health v. Hellerstedt, opponents of abortion have had to lay down their swords in several jurisdictions. Clinics in Mississippi, Wisconsin, Texas and Alabama will remain open, their admitting privileges and ambulatory surgical center provisions eviscerated. Advocates will now use the holding of Whole Woman's Health to argue against a raft of restrictions beyond the ones at issue in the case.

Louisiana holds the 2016 record for abortion-restricting laws, having passed seven, including a 72-hour waiting period and a ban on abortion after 20 weeks of pregnancy. Other laws ban research on the aborted fetuses, prohibit dilation and evacuation, ban medication abortion de facto, and attempt to police the reasons a woman chooses to end her pregnancy. If the laws take effect, the battle for access to safe abortion care will continue to rage.

The Center for Reproductive Rights has sued to block these laws immediately, citing the unconstitutional burden they impose upon women and providers. Commenting on the case, CRR's president Nancy Northrup remarked, "'Louisiana politicians are trying to do what the US Supreme Court just ruled decisively they cannot: burying women's right to safe and legal abortion under an avalanche of unjustified and burdensome restrictions."

The National Right to Life Committee met last week to discuss its strategy in light of the recent Supreme Court ruling in Whole Woman's Health v. Hellerstedt. The Supreme Court struck down Texas admitting privileges and ambulatory surgical requirements imposed on abortion clinics, finding that they imposed an undue burden on women's access to abortion. The case should make it difficult for states to justify targeted regulation of abortion providers, or TRAP laws, which impose more stringent regulatory requirements on doctors and facilities providing abortions than other comparable medical procedures.

Leaders of the NRLC indicated that rather than pushing TRAP laws, they will focus on passing legislation with the explicit purpose of protecting the fetus. Unlike TRAP laws that purport to impose medical regulations on abortions for the purpose of making the procedure safer (which the Supreme Court found was untrue in the case of the Texas regulations), laws seeking to protect the "humanity of the unborn" introduce a state purpose and benefit not at issue in Hellerstedt.

However, the two types of laws promoted by the NLRC pose their own constitutional problems. The NLRC is encouraging states to pass laws that ban abortion at 20 weeks (15 states have already passed 20 week bans) based on claims that the fetus can feel pain at 20 weeks. However current Supreme Court precedent prohibits bans on abortion prior to fetal viability, which is generally understood to occur at 22 weeks. There is also questionable medical support for the theory that the fetus can feel pain at 20 weeks, which is significant given the enhanced scrutiny that the Court employed in Hellerstedt to determine that the Texas regulations did not have the medical benefits claimed by the state.

The second provision backed by the NLRC would ban a technique used in second trimester abortions known as dilation and evacuation (D & E), which results removal of the fetus in parts. Only about 10% of abortions are performed after 12 weeks of pregnancy, and the provision does not change the situations in which women are entitled to obtain abortions. However, it significantly limits doctor and patient choice about how the procedure is performed. D & E is the most common form of second trimester abortion and is viewed by many doctors as the safest and most convenient technique for a later abortion. D & E bans have passed in Oklahoma and Kansas but have been blocked by courts because of their intrusion on women's medical procedures and because they could endanger women's health by exposing them to unneeded or more dangerous procedures.

Indiana Governor Mike Pence signed Indiana's draconian abortion bill into law on March 24th. Now, a campaign to call attention to the unbelievably restrictive law has emerged on Facebook. In an unusual strategy, the campaign, Periods for Pence, features a call for women to contact the governor's office "to report our periods." The campaign is meant to call specific attention to the requirement that miscarried fetuses be interred or cremated.

“I would certainly hate for any of my fellow Hoosier women to be at risk of penalty if they do not ‘properly dispose’ of this or report it,” one post says. “Just to cover our bases, perhaps we should make sure to contact Governor Pence’s office to report our periods.”

The Food and Drug Administration recently relaxed its guidelines for use of the abortion-inducing drug mifepristone, which is used in approximately one in four abortions. Arizona has passed a law requiring abortion providers to follow the original guidelines. The original guidelines, based on studies conducted in the 1990s, recommended doses of mifepristone that have since been deemed unnecessarily high and recommended its use in pregnancies of up to seven weeks, instead of the ten-week pregnancies. Medical researchers have determined that mifepristone is safe in pregnancies of up to ten weeks.

The conservative Christian group that promoted the legislation called the new F.D.A. guidelines outrageous. Opponents of the law see it as an attack on women.

A draconian anti-abortion bill has landed on Governor Mike Pence's desk, passed by a legislature determined to raise the stakes in the campaign conservatives are waging against a woman's right to choose. Described as a "reproductive Jim Crow law" by Salon reporter Bob Cesca, the bill contains a litany of targeted regulations of abortion providers (TRAPs) as well as" a ban on all abortions for elective reasons--and if the fetus suffers from any disability whatsoever." Women who are able to surmount the obstacles and have an abortion must pay for the burial or cremation of the fetus. In addition to the now-familiar ultrasound requirement, women will be required to listen to the fetal heartbeat. All of this is on top of the TRAP laws that have left all but four of Indiana’s 92 counties without an abortion facility.

North Carolina has one of the most restrictive abortion laws in the country, one the Hilary Clinton campaign has called "outrageous." Any doctor who performs an abortion after the 16th week of pregnancy must submit an ultrasound to the state. The state says it wishes to verify that doctors are not performing post-20-week abortions. Opponents of the law, which also extends the mandated waiting period for an abortion to 72 hours, call it an effort to intimidate both doctors, who know that determining gestational age is an inexact science, and women, who may hesitate before allowing information about their pregnancy to be shared with a governmental agency. The law also requires doctors performing abortions after 20 weeks to send the health department the findings and analysis that were used to determine that a medical emergency existed. The controversy has become an important issue in the political sphere, as Democrats harness liberal anger in an attempt to unseat the Republican governor Pat McCrory in his bid for a second term.

As discussed in previous posts, during the 2015 state legislative session, state legislatures adopted 57 new abortion restrictions. But the year was also memorable "because the politics of abortion ensnared family planning programs and providers, as well as critical, life-saving fetal tissue research."

At the same time, several states made important advances in 2015 on other sexual and reproductive health and rights issues. Some of the new provisions include measures that allow women to obtain a full year’s worth of prescription contraceptives at one time from a pharmacy, that allow a provider to treat a patient’s partner for an STI without first seeing the patient, that prohibit the use of “conversion therapy” with minors, and that expand access to dating or sexual violence education.

According to Guttmacher, in 2015, 11 states tried to cut funding for Planned Parenthood to any family family provider that also offers abortion. This could seriously impact family planning for low income women because Planned Parenthood health centers serve half or more of the women obtaining contraceptive care from safety-net health centers in two-third of the counties where they operate. Five states tried to exclude Planned Parenthood from the Medicaid program, although these efforts were blocked by federal courts. Ten states tried to regulate fetal tissue donation and research.

The New York Times reports that no fewer than 288 restrictions on abortion have been enacted since 2011. These include the familiar targeted regulation of abortion providers scheduled for review next year by the Supreme Court. But abortion is being attacked in other ways as well, including extensions of waiting periods, mandated in-person counseling necessitating two separate trips to an abortion provider, and bans on inexpensive medical abortions. Against the backdrop of the forceful move in many states to de-fund Planned Parenthood, the only reproductive health provider for millions of poor women, these efforts reflect an attempt not only to unduly burden but indeed to obliterate entirely every woman's right to manage her reproductive life.